Individual
MR. SEAN EDWARD ETIENNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3920 N UNION BLVD STE 200, COLORADO SPRINGS, CO 80907-4921
(719) 524-7616
Mailing address
3920 N UNION BLVD STE 200, COLORADO SPRINGS, CO 80907-4921
(719) 524-7616
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
116685
MN
183500000X
Pharmacist
Primary
12402-040
WI
1835P2201X
Ambulatory Care Pharmacist
PHA0019012
CO
Other
Enumeration date
11/06/2007
Last updated
02/26/2016
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